Brazilian Butt Lift: What We Learned Over 7000 Patients?

Gluteal fat grafting carries risk of pulmonary fat embolism and thromboembolic events. Standardized subcutaneous-only injection has been proposed to mitigate these risks.

To evaluate embolic events, thromboembolic complications, and overall safety outcomes in a large consecutive series of Brazilian Butt Lift (BBL) procedures using a standardized subcutaneous-only protocol.

Retrospective review of 7,000 consecutive BBL procedures performed between 2018 and 2024. Subcutaneous-only fat injection, stiff cannulas (>4 mm), retrograde technique, sacral and lateral access, and multimodal thromboembolism prophylaxis were employed. Demographics, operative variables, complications, and patient-reported satisfaction were analyzed.

No pulmonary fat embolism, fat embolism syndrome, deep vein thrombosis, or pulmonary embolism occurred. Estimated fat graft survival was approximately 70% with mean injection volumes of 1,200 cc per buttock. Minor complications included seroma (23%), anemia (6.6%), fat necrosis (1.9%), infection (0.43%), hematoma (0.14%), asymmetry (0.29%), and revision surgery (0.21%). Secondary procedures accounted for 3% of cases and demonstrated similar complication rates.

Strict subcutaneous-only injection and multimodal thromboembolism prophylaxis were associated with zero embolic events in this 7,000-case series. Minor complications were manageable. These data support standardized operative protocols to optimize safety in gluteal fat grafting.

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